Organization
PALMER PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAITLYN MARIE SULLIVAN PHARMD (OWNER)
(724) 265-1632
Entity
Organization
Contact information
Practice address
738 LITTLE DEER CREEK VALLEY ROAD, RUSSELLTON, PA 15076-0029
(724) 265-1632
(724) 265-1120
Mailing address
738 LITTLE DEER CREEK VALLEY ROAD PO BOX 29, RUSSELLTON, PA 15076-0029
(724) 265-1632
(724) 265-1120
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP411760L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036260510001
—
PA
01
—
2082069
PK
—
Enumeration date
12/14/2006
Last updated
07/15/2019
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